PEMBE ETHEM PSYD
NPI 1841674579
Psychologist in Redwood City, CA

Active since July 13, 2015Opted out of Medicare · through Jan 26, 2027
617 VETERANS BLVD STE 107, REDWOOD CITY, CA 94063(650) 204-4204 Get Directions Write a Review

NPPES record last updated: January 18, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Pembe Ethem Psyd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PEMBE ETHEM PSYD (NPI 1841674579) is an individual psychologist in Redwood City, California and active in the NPI registry since July 2015. She has opted out of Medicare through January 26, 2027.

NPPES Registry Identity

NPI1841674579
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NamePEMBE ETHEMCredential: PSYD
Location Address617 VETERANS BLVD STE 107Redwood City, CA 94063-1404
Mailing Address617 Veterans Blvd Ste 107Redwood City, CA 94063-1404 · (650) 204-4204
Sole ProprietorYes
Enumeration DateJuly 13, 2015
Last NPPES UpdateJanuary 18, 2023
NPPES CertifiedJanuary 18, 2023
NPI 1841674579 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Definition

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

617 VETERANS BLVD STE 107, Redwood City, CA 94063

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Pembe Ethem Psyd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 26, 2023 through January 26, 2027.

Opt-Out Effective DateJanuary 26, 2023
Opt-Out In Effect ThroughJanuary 26, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 16

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychologist
617 VETERANS BLVD STE 107
REDWOOD CITY, CA 94063
Psychologist
617 VETERANS BLVD STE 107
REDWOOD CITY, CA 94063
Psychologist (Clinical)
617 VETERANS BLVD STE 107
REDWOOD CITY, CA 94063
Counselor (Mental Health)
617 VETERANS BLVD STE 107
REDWOOD CITY, CA 94063
Social Worker (Clinical)
617 VETERANS BLVD STE 107
REDWOOD CITY, CA 94063
Psychologist (Clinical)
617 VETERANS BLVD STE 107
REDWOOD CITY, CA 94063
Psychologist (Clinical)
617 VETERANS BLVD STE 107
REDWOOD CITY, CA 94063
Marriage & Family Therapist
617 VETERANS BLVD STE 107
REDWOOD CITY, CA 94063

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pembe Ethem's NPI number?

The NPI number for Pembe Ethem is 1841674579. It was assigned to this individual provider in the NPPES registry on July 13, 2015.

Where is Pembe Ethem located?

Pembe Ethem practices at 617 Veterans Blvd Ste 107, Redwood City, CA 94063. The listed phone number is (650) 204-4204.

What is Pembe Ethem's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Pembe Ethem enrolled in Medicare?

No. Pembe Ethem has opted out of Medicare through January 26, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Pembe Ethem was last updated on January 18, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.